Actinic prurigo - Skin
AP appears during childhood, typically in females, at about 10-14 years of age on average.
AP is considered a familial dermatosis that is found predominantly in Native Americans and mixed ancestry (Mestizo) populations of Mexico and Central and South America. It has also been described less frequently in white and Asian populations.
- Intense pruritus
- Pruritus, tingling, or pain of the vermilion border (83%)
- Ocular symptoms – photophobia, pruritus, and lacrimation
- Excoriated papules are apparent, mostly on uncovered skin of the face and distal extremities, but AP can also involve covered sites, especially the lower back and buttocks.
- Cheilitis (28%)
- Conjunctivitis (associated conjunctivitis is uncommon in whites)
The disorder often appears during childhood and resolves after puberty. Less commonly, onset may occur in adulthood. In the latter the eruption seems to be more chronic.
L57.8 – Other skin changes due to chronic exposure to nonionizing radiation
201015007 – Actinic prurigo
- Polymorphous light eruption (PMLE) – no HLA associations; occurs later, in second and third decades of life; edematous papules and plaques appear from hours to 1-2 days aftersun exposure; affects exposed skin but often spares the face due to UV exposure year-round; may improve as summer progresses.
- Solar urticaria – lesions appear within minutes of sun exposure.
- Hydroa vacciniforme – umbilicated vesicles on sun-exposed skin.
- Systemic lupus erythematosus – skin biopsies, ANA, anti-Ro, and anti-La antibodies may help distinguish.
- Juvenile spring eruption – variant of PMLE occurring on the ear helices.
- Porphyria – check urine and serum porphyrins.
- Photoaggravated atopic dermatitis – assess for personal and family history of atopy, predominance in flexures; should respond to usual eczema treatment.
- Lymphomatoid papulosis – skin biopsies.